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7 APRIL 2008
NO 1282
Treatment goals
To work successfully with these children the therapist needs to be clear about treatment goals, and to develop a sense of priorities. Adults who are used to dealing with children with less severe problems, or adults who rely solely on their personal life experience and upbringing, may seriously underestimate severely mistreated children's disturbance. This misassessment often is based on the child's normal or appealing physical appearance, or the child's selfcontrol during periods that are not stressful. It can lead adults to establish goals or to have expectations that are unrealistic. When the children fail to meet these goals, the adults may get angry and discouraged. Out of disappointment, doubts surface about the children's treatability, and staff members drift toward using more punitive measures. Both the children's and clinicians' morale can deteriorate.
In our experience, the safest (and most realistic) course of action is to presume that the children are doing the best they can under the circumstances, and to focus on achieving the most basic goal – living together as comfortably as possible. The staff ought to aim to get through each block of time, each shift or each day perhaps, in a way that leaves the children and the caregiving adults feeling good about the day and about their experience together. Although this goal seems minimal, in practical terms it is quite ambitious with children who have had so few days that have not been filled with tension and upheaval.
ALVIN ROSENFELD AND
SAUL WASSERMAN
Rosenfeld, A. and Wasserman, S. (1990). Healing
the Heart: A therapeutic approach to disturbed children in group care.
Washington,D.C. Child Welfare League of America. p.47.
